Frontiers in Cardiovascular Medicine最新文献

{"title":"Left ventricular outflow tract obstruction after transcatheter mitral valve replacement: a case report with a multifaceted approach.","authors":"Berenice Caneiro-Queija, Claudio E Guerreiro, Julio Echarte-Morales, Rodrigo Estévez-Loureiro, Manuel Barreiro-Pérez, Rocío González-Ferreiro, Francisco Estévez-Cid, Juan José Legarra, Jose Antonio Baz, Andrés Íñiguez-Romo","doi":"10.3389/fcvm.2024.1431639","DOIUrl":"10.3389/fcvm.2024.1431639","url":null,"abstract":"<p><p>An 83-year-old woman was admitted to our center because of heart failure. Transthoracic echocardiography revealed severe mitral annular calcification resulting in a double mitral valve lesion. After discussion by the heart team, transcatheter mitral valve replacement with Tendyne (Abbott Structural, Santa Clara, CA, USA) was performed. Despite having a predicted neo-left ventricular outflow tract (LVOT) above the cut-off value, the patient developed clinically significant LVOT obstruction (LVOTO) refractory to medical treatment. This situation is often treated before the intervention, and dealing with LVOTO afterward can be challenging. After taking the patient's anatomy into consideration, we decided to perform alcohol septal ablation. Applying a combined strategy of medical treatment and intervention led to success. In this case report, we discuss this event and the strategies available for preventing and managing the condition.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The left axillary artery is a reasonable option as the inflow site for saphenous vein graft in minimally invasive coronary artery bypass grafting.","authors":"Ryohei Ushioda, Aina Hirofuji, Dit Yoongtong, Boonsap Sakboon, Jaroen Cheewinmethasiri, Thanin Lokeskrawee, Jayanton Patumanond, Suppachai Lawanaskol, Hiroyuki Kamiya, Nuttapon Arayawudhikul","doi":"10.3389/fcvm.2024.1397396","DOIUrl":"10.3389/fcvm.2024.1397396","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to clarify the good inflow site for saphenous vein grafts (SVG) in minimally invasive off-pump coronary artery bypass grafting (mini-CABG), between the ascending aorta, the internal thoracic arteries (ITAs) and the left axillary artery (LAA).</p><p><strong>Methods: </strong>This retrospective study included 126 patients who underwent Mini-CABG at our center between January 2014 and July 2023. Patients were divided into three groups according to the SVG inflow site for patency comparison: Aorta group (<i>n</i> = 56), LAA group (<i>n</i> = 23), and ITA group (<i>n</i> = 47).</p><p><strong>Results: </strong>There were 84 males, with mean age of 65.9 ± 7.0 years. There were no significant differences in preoperative characteristics between groups. Mean operation times were 254.6 ± 72.2, 213.7 ± 57.6, and 253.0 ± 81.2 min, and the average numbers of distal anastomoses were 2.9 ± 0.9, 2.4 ± 0.7 and 2.9 ± 1.1 in the Aorta, ITA and LAA groups respectively. Days in intensive care, hospital stay, and major complications did not differ between the groups. Early patency of SVG did not significantly differ among groups: 93.0% in the Aorta group, 98.0% in the ITA group, and 100% in the LAA group. Mean follow-up period was 136.7 ± 295.7 days, and follow-up coronary CTA revealed 18 SVG occlusions (Aorta group <i>n</i> = 8, ITA group <i>n</i> = 5, LAA group <i>n</i> = 5). The Kaplan-Meier curve for SVG patency rates did not show any significant differences among the three groups.</p><p><strong>Conclusion: </strong>The ascending aorta, the ITAs, and the LAA serve as reliable inflow sites with similar results in mini-CABG.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between apolipoprotein C-III levels and coronary calcification detected by intravascular ultrasound in patients who underwent percutaneous coronary intervention.","authors":"Tatsuya Fukase, Tomotaka Dohi, Ryota Nishio, Mitsuhiro Takeuchi, Norihito Takahashi, Yuichi Chikata, Hirohisa Endo, Shinichiro Doi, Hiroki Nishiyama, Iwao Okai, Hiroshi Iwata, Seiji Koga, Shinya Okazaki, Katsumi Miyauchi, Hiroyuki Daida, Tohru Minamino","doi":"10.3389/fcvm.2024.1430203","DOIUrl":"10.3389/fcvm.2024.1430203","url":null,"abstract":"<p><p>There are few reports on the association between apolipoprotein C-III (ApoC-III) and coronary calcification using intravascular modalities. This study aimed to investigate the impacts of ApoC-III levels on coronary calcification using grayscale intravascular ultrasound (IVUS). Consecutive 263 culprit lesions for 202 patients who underwent percutaneous coronary intervention using grayscale IVUS were included in this study and divided into four groups based on quartile ApoC-III values. This study assessed plaque characteristics, including severe calcification (>180° arc) at the minimum lumen area site and presence of calcified nodules within the culprit lesion using grayscale IVUS, and evaluated whether ApoC-III levels were associated with coronary calcified plaques. The highest ApoC-III quartile [Quartile 4 (Q4)] had a higher proportion of complex lesions, calcified plaques, severe calcification, calcified nodules, plaque burden, and total atheroma volume than the lowest ApoC-III quartile [Quartile 1 (Q1)]. Additionally, multivariable logistic regression analysis showed that Q4 was significantly associated with severe calcification and calcified nodules, with Q1 as the reference (odds ratio [OR]: 2.70, 95% confidence intervals [CIs]: 1.04-7.00, <i>p </i>= 0.042; and OR: 3.72, 95% CIs 1.26-11.0, <i>p </i>= 0.017, respectively). Furthermore, ApoC-III level (1-mg/dl increase) was a strong significant predictor of severe calcification (OR: 1.07, 95% CIs: 1.00-1.15, <i>p </i>= 0.040) and calcified nodules (OR: 1.09, 95% CIs: 1.01-1.19, <i>p </i>= 0.034) according to the multivariable logistic regression analysis. This study is the first to verify that elevated ApoC-III levels are associated with the development of severe calcification and progression to calcified nodules as detected by grayscale IVUS.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delta-wave automatic mapping of the manifest accessory pathway.","authors":"Saverio Iacopino, Gennaro Fabiano, Paolo Sorrenti, Andrea Petretta, Jacopo Colella, Alessandro Di Vilio, Giovanni Statuto, Nicolangelo Diomede, Paolo Artale, Pasquale Filannino, Antonino Pardeo, Filippo Placentino, Giuseppe Campagna, Gianluca Peluso, Edoardo Cecchini, Federico Cecchini, Giuseppe Speziale, Fiorenzo Gaita","doi":"10.3389/fcvm.2024.1449038","DOIUrl":"10.3389/fcvm.2024.1449038","url":null,"abstract":"<p><strong>Background: </strong>Despite the high success rate of radiofrequency catheter ablation (RFCA) in Wolff-Parkinson-White Syndrome (WPW), localizing the successful ablation site can be challenging and may require multiple radiofrequency (RF) applications.</p><p><strong>Objective: </strong>This study aims to evaluate the efficacy of a novel workflow for the automatic and precise identification of accessory pathway ablation site, named Delta Wave Automatic Mapping.</p><p><strong>Methods: </strong>Patients undergoing a first procedure for RF ablation of a manifest accessory pathway were included. Electro-Anatomical Mapping (EAM) was performed with the CARTO 3 system (Biosense Webster, Johnson & Johnson Medical S.p.a., Irvine, CA) leveraging auto-acquisition algorithms already present in the CARTO 3 software. Mapping and ablation were performed with an irrigated tip catheter with contact force sensor. Procedure success was defined as loss of pathway function after ablation. The number of RF applications required and time to effect were measured for each patient. Recurrences were evaluated during follow-up visits. Additionally, at the end of each procedure, historical predictors of ablation success were measured offline to evaluate their relationship with the successful ablation site found with the novel workflow.</p><p><strong>Results: </strong>A total of 50 patients were analysed (62% APs right and 38% APs left). All 50 APs were successfully eliminated in each procedure with a median Time-to-effect (TTE) of 2.0 (IQR 1.2-3.5) seconds. No AP recurrences during a median follow-up of 10 (IQR 6-13) months were recorded. Offline analysis of successful ablation site revealed a pre-ablation delta/ventricular interval of ≤-10 msec in 52% of the patients and in 100% of the patients the signal related to the Kent bundle was identified.</p><p><strong>Conclusions: </strong>The novel workflow efficiently localizes APs without requiring manual annotations. Historical endocardial parameters predicting success were measured offline for each case and they corresponded to the ablation target automatically annotated by the proposed workflow. This novel mapping workflow holds promise in enhancing the efficacy of RFCA in the presence of manifest APs.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram for individualized prediction of new-onset postoperative atrial fibrillation in acute type A aortic dissection patients: a retrospective study.","authors":"Zhihao Yang, Chunxiao Liu, Chao Fu, Xin Zhao","doi":"10.3389/fcvm.2024.1429680","DOIUrl":"10.3389/fcvm.2024.1429680","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to explore the risk factors associated with new-onset postoperative atrial fibrillation (POAF) following Sun's surgery(total arch replacement using a tetrafurcate graft with stented elephant trunk implantation) for acute type A aortic dissection(AAAD) and to develop a predictive model for assessing the likelihood of new-onset POAF in patients undergoing Sun's surgery for AAAD.</p><p><strong>Methods: </strong>We reviewed the clinical parameters of patients diagnosed with AAAD who underwent Sun's surgery at Qilu Hospital between December 1, 2017 and December 31, 2022. The data was analyzed through univariable and multivariable logistic regression analysis. Variance inflation factor was used to investigate for variable collinearity. A nomogram for predicting new-onset POAF was developed and verified by bootstrap resampling. In addition, the calibration of our model was evaluated by the calibration curve and Hosmer-Lemeshow test. Furthermore, the clinical utility of our model was evaluated using the net benefit curve.</p><p><strong>Results: </strong>This study focused on a cohort of 242 patients with AAAD, among whom 42 experienced new-onset POAF, indicating an incidence rate of 17.36%. Age, left atrial diameter (LA), right atrial diameter (RA), preoperative red blood cells (RBC), and previous acute coronary syndrome (preACS) emerged as independent influences on new-onset POAF following Sun's surgery, as identified by univariable and multivariable logistic regression analysis. Collinearity analysis with demonstrated no collinearity among the variables. A user-friendly prediction nomogram for new onset POAF following Sun's surgery was formulated. The model demonstrated commendable diagnostic accuracy with an area under the curve (AUC) of 0.7852. Validation of the model through bootstrapping (1,000 repetitions) yielded an AUC of 0.8080 (95% CI: 0.8056-0.8104). affirming its robustness. Additionally, the model exhibited favorable fit, calibration, and positive net benefits in decision curve analysis.</p><p><strong>Conclusions: </strong>Drawing upon these findings, we have developed a predictive model for the occurrence of new-onset POAF. These results suggest the potential efficacy of this prediction model for identifying patients at risk of developing POAF. The visualization of this model empowers healthcare professionals to conveniently and promptly assess the risk of AF in patients, thereby facilitating the timely intervention implementation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of combining urinary N-acetyl-β-D-glucosaminidase and serum homocysteine for contrast-induced nephropathy in patients after percutaneous coronary intervention.","authors":"Yiling Zhai, Changjun Luo, Nianying Qin, Hongying Cao, Chunyang Dong, Zhou Huang, Dongling Huang, Fan Wang, Wanxia Wei, Jincheng Li, Jie Yang, Xueling Lu, Zhengzhuang Huang, Wei Wang","doi":"10.3389/fcvm.2024.1423836","DOIUrl":"10.3389/fcvm.2024.1423836","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced nephropathy (CIN) can lead to serious complications following percutaneous coronary intervention (PCI). Urine N-Acetyl-β-D-glucosaminidase (uNAG) and serum homocysteine (sHCY) are both potential predictors for CIN detection, but their combination has not been explored. We aimed to combine uNAG and sHCY as predictors for the early detection of CIN and for prognosis prediction in patients after PCI.</p><p><strong>Methods: </strong>A total of 232 consecutive patients who underwent PCI at a university hospital were recruited for this study. According to the European Society of Urology and Reproduction (ESUR) criterion, CIN is defined as an elevation of serum creatinine (sCr) by ≥25% or ≥0.5 mg/dl from baseline within 48 h. We assessed the use of individual biomarkers (uNAG and sHCY) measured around PCI and their combinations for CIN detection and prognosis prediction. Receiver operating characteristic curves (ROC) and area under the curve (AUC) were used to evaluate the predictive efficiency of potential predictors.</p><p><strong>Results: </strong>In total, 54 (23.28%) patients developed CIN. Concentrations of uNAG and sHCY increased significantly in CIN subjects (<i>p </i>< 0.05) than non-CIN. CIN could be predicted by uNAG and sHCY but not by creatinine at an early stage. At pre-PCI, 0, 12, 24, and 48 h after PCI, the AUC-ROC value of uNAG in calculating total CIN was 0.594, 0.603, 0.685, 0.657, and 0.648, respectively. The AUC-ROC value of sHCY in calculating total CIN was 0.685, 0.726, 0.771, 0.755, and 0.821, respectively. The panel of uNAG plus sHCY detected CIN with significantly higher accuracy than either individual biomarker alone and earlier than sCr. For detecting total CIN, this panel yielded AUC-ROCs of 0.693, 0.754, 0.826, 0.796, and 0.844 at pre-PCI, 0, 12, 24, and 48 h after PCI, respectively, which were superior to those of the individual biomarkers. For predicting the incidence of major adverse cardiovascular events (MACE) within 30 days to 12 months, the AUC-ROC values for uNAG and sHCY measured before discharge were 0.637 and 0.826, respectively. The combined panel yielded an AUC-ROC of 0.832. The combined detection did not significantly enhance the predictive capability for MACE in patients with CIN. The CIN group and the non-CIN group showed no significant difference in the Coronary Heart Disease Intensive Care Unit (CCU) stay time, hospital stay time, demand for renal replacement therapy, CCU mortality rate, and in-hospital mortality rate.</p><p><strong>Conclusions: </strong>The uNAG and sHCY panel demonstrated better sensitivity and specificity for predicting the diagnosis and prognosis of CIN in patients after PCI, earlier than sCr. The combination of these biomarkers revealed a significantly superior discriminative performance for CIN detection and prognosis compared to using uNAG or sHCY alone.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of inflammatory proteins in regulating the impact of lipid specifications on deep venous thrombosis: a two sample and mediated Mendelian randomization study.","authors":"Fan Dong, Jiahao Sun, Yudong Zhang","doi":"10.3389/fcvm.2024.1434600","DOIUrl":"10.3389/fcvm.2024.1434600","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential mediating role of inflammatory proteins in the association between lipid species and Deep Venous Thrombosis (DVT).</p><p><strong>Methods: </strong>A comprehensive analysis was conducted using pooled data from genome-wide association studies (GWAS), incorporating double-sample and reverse Mendelian randomization (MR) techniques, to identify the specific inflammatory proteins that act as intermediaries among 91 screened proteins in relation to deep vein thrombosis (DVT). Furthermore, a two-step MR approach was employed to quantify the proportion of DVT risk attributed to lipid effects mediated by these inflammatory proteins.</p><p><strong>Results: </strong>The MR Analysis revealed that the two inflammatory proteins, as predicted by genetics, served as mediating factors in the impact of five lipids on DVT. No reverse effect of DVT was observed on 179 lipid species and 91 inflammatory proteins. In the case of TAG(58:7) and its influence on DVT, CCL20 played an intermediary role with an estimated proportion of 12.51% (ranging from 12% to 13%). SIRT2 exhibited a masking effect on DVT for PC(17:0/20:4) and PC(18:0/20:4), while CCL20 masked the impact of DVT on PC(14:0/18:2), PC(15:0/18:2), and PC(18:0/20:5).</p><p><strong>Conclusions: </strong>In our study, we identified CCL20 as a crucial mediator in the association between TAG(58:7) and DVT, with a mediating proportion of 12.51% (12%-13%). Further investigations are warranted to explore other potential risk factors acting as mediators.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blunted cardiac autonomic dynamics to active standing test in postmenopausal women.","authors":"Costanza Scatà, Felipe C Ferreira, Michelle C S V Padilha, Angelica Carandina, Riccardo Asnaghi, Chiara Bellocchi, Eleonora Tobaldini, Nicola Montano, Pedro Paulo da S Soares, Gabriel D Rodrigues","doi":"10.3389/fcvm.2024.1402086","DOIUrl":"10.3389/fcvm.2024.1402086","url":null,"abstract":"<p><strong>Introduction: </strong>Although both aging and menopause influence cardiovascular autonomic control, the effect of menopause <i>per se</i> remains unclear. The current study was undertaken to test the hypothesis that post-menopausal women (PMW) have a blunted cardiovascular autonomic adjustment to active standing compared to pre-menopausal women. Thus, we compared the heart rate variability (HRV) indexes from supine (SUP) to orthostatic (ORT) positions among young women (YW), young men (YM), older men (OM), and PMW.</p><p><strong>Methods: </strong>The participants rested for 10 min in SUP and then stood up and remained for 5 min in ORT. ECG was continuously recorded, and R-R time series of about 300 beats were analyzed using linear (spectral analysis) and non-linear (symbolic analysis) methods. The variation from SUP to ORT was calculated (<i>Δ</i> = ORT-SUP) for each HRV index.</p><p><strong>Results: </strong>In SUP, no difference was found for any HRV index among groups. However, <i>Δ</i>0V% and <i>Δ</i>LFn (cardiac sympathetic modulation) were reduced in PWM compared to all groups (OM, YW, and YM), while <i>Δ</i>2UV% and <i>Δ</i>HFn (cardiac vagal modulation) were reduced in PMW than the younger group (YW and YM). No differences were found among the male groups (OM and YM).</p><p><strong>Discussion: </strong>In light of our results, the cardiac autonomic dynamic response to orthostatic stress is blunted in post-menopausal women compared to younger women and older men, a finding that might be influenced not only by aging.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamics in the treatment of pseudoaneurysm caused by extreme constriction of aortic arch with coated stent.","authors":"Lanlan Li, Yiwei Wang, Ping Jin, Tingting Yang, Guangyu Zhu, Yuxi Li, Jiayou Tang, Yang Liu, Jian Yang","doi":"10.3389/fcvm.2024.1363230","DOIUrl":"10.3389/fcvm.2024.1363230","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the changes in distal vascular morphology and hemodynamics in patients with extremely severe aortic coarctation (CoA) after covered palliative (CP) stent dilation with different surgical strategies.</p><p><strong>Materials and methods: </strong>Perioperative computed tomography angiography and digital subtraction angiography were utilized to construct three aortic models with varying stenosis rates and one follow-up model in a patient with extremely severe CoA. The models included: an idealized non-stenosed model (A: 0%), a model post initial stent deployment (B: 28%), a model post balloon expansion (C: 39%), and a model 18 months after post-balloon expansion (D: 39%). Consistent boundary conditions were applied to all models, and hemodynamic simulation was conducted using the pure fluid method.</p><p><strong>Results: </strong>The narrowest and distal diameter of the stent increased by 34.71% and 59.29%, respectively, from model B to C. Additionally, the distal diameter of the stent increased by -13.80% and +43.68% compared to the descending aorta diameter, respectively. Furthermore, the ellipticity of the maximum cross-section of the aneurysm region in model A to D continued to increase. The oscillatory shear index at the stenosis to the region of the aneurysm were found to be higher in Models A and B, and lower in Models C and D. At the moment of maximum flow velocity, the blood flow distribution in models A and B was more uniform in the widest section of the blood vessels at the distal end of the stenosis, whereas models C and D exhibited disturbed blood flow with more than 2 eddy currents. The time-averaged wall shear stress (TAWSS) decreased in the distal and basal aneurysms, while it significantly increased at the step position. The aneurysmal region exhibited an endothelial cell activation potential value lower than 0.4 Pa^-1.</p><p><strong>Conclusion: </strong>In patients with extremely severe CoA, it is crucial to ensure that the expanded diameter at both ends of the CP stent does not exceed the native vascular diameter during deployment. Our simulation results demonstrate that overdilation leads to a decrease in the TAWSS above the injured vessel, creating an abnormal hemodynamic environment that may contribute to the development and enlargement of false aneurysms in the early postoperative period.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, (NCT02917980).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of phenylalanine in predicting atrial fibrillation risk in chronic heart failure.","authors":"Qing-Fen Zhou, Qiu-Ya Lu, Yang Dai, Qiu-Jing Chen, Xiao-Shuang He, Shuai Chen, Jun-Tao Zhao, Feng-Ru Zhang, Lin Lu, Fan Yang","doi":"10.3389/fcvm.2024.1392548","DOIUrl":"10.3389/fcvm.2024.1392548","url":null,"abstract":"<p><strong>Backgrounds: </strong>Atrial fibrillation (AF) is a common complication of chronic heart failure (HF). Serum phenylalanine (Phe) levels are related to inflammation disorder. It is meaningful to study the circulating Phe with AF occurrence in HF.</p><p><strong>Methods: </strong>The cross-sectional study recruited 300 patients (78.0% male; mean age, 65 ± 13 years) with HF (left ventricular ejection fraction of ≤50%, containing 70 AF patients) and 100 normal controls. Serum Phe value was measured by liquid chromatography-tandem mass spectrometry. Logistic regression analysis was conducted to measure the association between Phe and AF risk in HF. The association between Phe and high-sensitivity C-reactive protein (hsCRP) was assessed by simple correlation analysis. In the prospective study, the 274 HF subjects (76.6% male; mean age, 65 ± 13 years) were followed up for a mean year (10.99 ± 3.00 months).</p><p><strong>Results: </strong>Serum Phe levels increased across the control, the HF without AF, and the HF with AF groups (77.60 ± 8.67 umol/L vs. 95.24 ± 28.58 umol/L vs. 102.90 ± 30.43 umol/L, ANOVA <i>P</i> < 0.001). Serum Phe value was the independent risk factor for predicting AF in HF [odds ratio (OR), 1.640; 95% CI: 1.150-2.339; <i>P</i> = 0.006]. Phe levels were correlated positively with hsCRP value in HF patients with AF (<i>r</i> = 0.577, <i>P</i> < 0.001). The elevated Phe levels were associated with a higher risk of HF endpoint events in HF patients with AF (log-rank <i>P</i> = 0.005).</p><p><strong>Conclusions: </strong>In HF with AF subjects, elevated Phe value confers an increased risk for prediction AF and was more related to poor HF endpoint events. Phe can be a valuable index of AF in HF.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}